I 

118TH CONGRESS 

2D SESSION H. R. 9157 

To amend title XVIII of the Social Security Act to facilitate patient access 

to certain pediatric technologies. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 25, 2024 

Mr. JOYCE of Pennsylvania (for himself and Mrs. TRAHAN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to facilitate 

patient access to certain pediatric technologies. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Access to Pediatric 

5 Technologies Act of 2024’’. 


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1 SEC. 2. FACILITATING ACCESS TO PEDIATRIC TECH2 NOLOGIES. 

3 (a) IN GENERAL.—Section 1848 of the Social Secu4 rity Act (42 U.S.C. 1395w–4) is amended by adding at 

5 the end the following new subsection: 

6 ‘‘(u) FACILITATING ACCESS TO PEDIATRIC TECH7 NOLOGIES.— 

8 ‘‘(1) IN GENERAL.—For each qualifying pedi9 atric technology (as defined in paragraph (4)) fur10 nished on or after January 1, 2026, the Secretary 

11 shall, upon receipt of a manufacturer request under 

12 paragraph (3), establish national relative value units 

13 under the physician fee schedule established under 

14 this section, to the extent no such national relative 

15 value units have been established for such qualifying 

16 pediatric technology under such fee schedule. 

17 ‘‘(2) PAYMENT METHODOLOGY.—The Secretary 

18 shall establish national relative value units for a 

19 qualifying pediatric technology under this sub20 section— 

21 ‘‘(A) in accordance with the payment 

22 methodology established under this section and 

23 applicable regulations; and 

24 ‘‘(B) using available data related to the 

25 qualifying pediatric technology, which may in26 clude applicable contractor pricing information, 


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1 claims data, time and motion studies, invoice 

2 information, or other information used by the 

3 Secretary in establishing payment rates. 

4 ‘‘(3) IMPLEMENTATION.— 

5 ‘‘(A) IN GENERAL.—Upon written request 

6 to the Secretary from the manufacturer of a 

7 qualifying pediatric technology, the Secretary 

8 shall establish national relative value units 

9 under paragraph (1) through the annual rule10 making process for the physician fee schedule 

11 established under this section, in accordance 

12 with the timeline described in subparagraph 

13 (B). 

14 ‘‘(B) TIMELINE.— 

15 ‘‘(i) In the case where the Secretary 

16 receives a request under this paragraph on 

17 or before May 1 of a given year from a 

18 manufacturer with respect to a qualifying 

19 pediatric technology of the manufacturer, 

20 the Secretary shall establish national rel21 ative value units for the qualifying pedi22 atric technology in the rulemaking process 

23 during that year for the physician fee 

24 schedule established under this section. 


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1 ‘‘(ii) In the case where the Secretary 

2 receives a request under this paragraph 

3 after May 1 of a given year from a manu4 facturer with respect to a qualifying pedi5 atric technology of the manufacturer, the 

6 Secretary shall establish national relative 

7 value units for the qualifying pediatric 

8 technology in the rulemaking process dur9 ing the following year for the physician fee 

10 schedule established under this section. 

11 ‘‘(C) CONTENT OF MANUFACTURER RE12 QUESTS.—A manufacturer submitting a request 

13 under paragraph with respect to a qualifying 

14 pediatric technology of the manufacturer shall 

15 include in such request information to verify 

16 that the technology is a qualifying pediatric 

17 technology and to allow the Secretary to estab18 lish national relative value units for such tech19 nology, including (to the extent available) con20 tractor pricing information, claims data, time 

21 and motion studies, invoice information, or 

22 other relevant information. 

23 ‘‘(4) QUALIFYING PEDIATRIC TECHNOLOGY DE24 FINED.—In this subsection, the term ‘qualifying pe25 diatric technology’ means a medical device that is— 


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1 ‘‘(A) covered under this title; 

2 ‘‘(B) approved, cleared, or authorized 

3 under section 510(k), 513(f)(2), or 515 of the 

4 Federal Food, Drug, and Cosmetic Act (21 

5 U.S.C. 360(k), 360c(f)(2), 360e); 

6 ‘‘(C) described by a temporary Level I 

7 HCPCS Code intended for emerging tech8 nologies, services, or procedures; and 

9 ‘‘(D)(i) used as part of a procedure pre10 dominantly performed on pediatric patients; or 

11 ‘‘(ii) has otherwise been specifically de12 signed for safe and effective use in pediatric 

13 populations. 

14 ‘‘(5) RULE OF CONSTRUCTION.—Nothing in 

15 this subsection shall be construed to require cov16 erage of a qualifying pediatric technology under this 

17 title or alter the requirements of section 

18 1862(a)(1)(A).’’. 

Æ 


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